# Efficacy and factors of 3D-printed guide-assisted hollow screw internal fixation for femoral neck fractures in the elderly

## TL;DR

3D-printed guides help improve hip function and quality of life for elderly patients with femoral neck fractures during surgery.

## Contribution

This study demonstrates the efficacy of 3D-printed percutaneous guide templates in enhancing surgical outcomes for femoral neck fractures.

## Key findings

- The 3D-PPGTA group had significantly higher Oxford Hip Scores than the HSIF group.
- Better SF-36 scores in the 3D-PPGTA group were observed in multiple domains.
- Shorter time to surgery and quicker healing were linked to better outcomes in the 3D-PPGTA group.

## Abstract

Femoral neck fractures in the elderly present significant challenges due to the complexity of the fractures and the fragility of patients. Traditional hollow screw internal fixation (HSIF) necessitates precise screw placement, which can be difficult due to compromised bone quality. This study explores the efficacy of 3D-printed percutaneous guide templates (3D-PPGTA) in assisting HSIF for improved surgical outcomes.

A retrospective analysis was conducted on 233 elderly patients with femoral neck fractures treated between June 2015 and December 2023. Patients were divided into HSIF (n = 128) and 3D-PPGTA (n = 105) groups. Outcomes were assessed using the Oxford Hip Score (OHS) and Short-Form Health Survey (SF-36), evaluating hip function, quality of life, and surgical success.

One-year post-surgery, the 3D-PPGTA group showed significantly higher OHS (35.73 ± 1.65) than the HSIF group (27.41 ± 1.07, p < 0.001), indicating superior hip function. The SF-36 revealed significantly better scores in the 3D-PPGTA group for Physical Functioning (67.66 ± 7.36 vs. 65.26 ± 7.44, p = 0.015), Bodily Pain (66.11 ± 5.21 vs. 64.16 ± 5.88, p = 0.009), General Health (54.89 ± 5.23 vs. 52.88 ± 4.56, p = 0.002), and Vitality (51.12 ± 4.98 vs. 49.76 ± 4.11, p = 0.026). Factors such as shorter time to surgery, delayed weight-bearing, and quicker fracture healing were associated with better outcomes in subgroup analysis within the 3D-PPGTA cohort (p < 0.05). The 3D-PPGTA procedure was associated with improved functional outcomes without increasing surgical risks.

The use of 3D-printed guide templates for assisted internal fixation is associated with improved functional recovery and quality of life in elderly patients with femoral neck fractures. The potential for enhanced operative precision warrants further investigation with radiographic metrics.